Healthcare Provider Details

I. General information

NPI: 1275049231
Provider Name (Legal Business Name): EUGENIA FOSTER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 01/21/2022
Certification Date: 01/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 FREDERICK AVE
BALTIMORE MD
21229-5987
US

IV. Provider business mailing address

8702 DULWICK CT APT 34
LAUREL MD
20708-3491
US

V. Phone/Fax

Practice location:
  • Phone: 301-456-0528
  • Fax:
Mailing address:
  • Phone: 443-447-3362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC8125
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC20001241
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701007497
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC8125
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: